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EMRs Continue To Raise Malpractice Litigation Risks For Hospitals

Posted on May 18, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

EMRs may yet realize the massive value proposition their fans imagine, but before they get there hospitals still have to roll down a bumpy road.  One threat that continues to loom over hospital EMRs — even if CIOs succeed at battling their high cost and complexity — is the distinct possibility that they will generate new categories of malpractice risk.

With EMRs being increasingly targeted in medical malpractice suits, hospitals and doctors need to be prepared for attacks of this kind. According to a data review by physician-owned med mal insurer the Doctors Company, EMRs were a part of med mal litigation in just 1% of a sample of suits closed between 2007 and 2013, but the frequency doubled between 2013 and 2014 alone, according to a report in Politico. That still only adds up to 2% of cases, but experts expect the number of EMR-involved medical malpractice suits to climb rapidly.

What’s more, trying to bury the mistakes by altering medical records can be a serious mistake. For example, notes an article in Medscape, the documentation which serves as a shield against malpractice accusations can also reveal details of when suspicious changes have been made. While clinicians may not always remember this, EMRs make changes in records after care has been given very easy to trace, something which can end up as quite damning if a patient care outcome is poor.

One particularly common trouble spot for EMR-related errors is self-populating templates, which, while they make life easier for doctors by capturing a patient’s recent medical history, can also create grounds for serious misunderstandings or medical errors.  For example, at a conference attended by Medscape editors, one speaker told the story of a template which generated text saying the patient had had hip surgery — but the patient had actually had a spinal procedure.

Other mistakes EMRs can cause include faulty voice recognition, misinterpretation of drop-down menus, reliance on outdated or error-ridden records and typos that generate medical errors.

However, organizations that are prepared can avoid many of these errors. In an effort to do so, some hospitals and health systems are studying how technologies like EMRs will fit into their workflow. These facilities and systems are creating human-factor teams that conduct simulations in hopes of catching error-causing issues with EMR use before such errors become an issue.  While such teams are not common — though they should be! — a report in iHealthBeat notes that the Society for Simulation in Healthcare had identified at least 165 simulation centers in the U.S. as of summer 2014.

Studying what impact a complex health IT system like an EMR will have on a healthcare staffers seems like a sensible and even brain-dead obvious move. But if less than 200 of the 5,000-odd hospitals are doing so, the healthcare industry has a lot of work to do before it can truly say EMRs are safe.

Study: VistA Is Doctors’ Favorite EMR, Beating Epic

Posted on November 26, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Despite more than a decade to work things out, discussions about open source vs. commercial enterprise software always seem to devolve into “religious wars” over the inherent goodness of one business model over the other.  EMR software seems to be no exception to this rule, a state of affairs which has done little to advance the industry as a whole.

Well, maybe the following will help move the discussion into more positive channels.  According to a new survey by Medscape, physicians prefer VistA over Epic, as well as Cerner, Meditech and McKesson, on characteristics which included ease of learning, reliability, value for the money, physician overall satisfaction and staff overall satisfaction.

According to the study, VistA came in at 3.89 out of 5 (five being “like most”), while Epic followed at 3.51, Cerner at 3.15, Meditech at 2.94 and McKesson at 2.91. (The pack was actually led by Amazing Charts (4.22) and Practice Fusion (4.04), both systems aimed at physician practices directly.)

Lest this seem like a flash in the pan, consider the results of a similar study done by the American Academy of Family Physicians in 2011. The AAFP, which asked physicians to compare 30 EMRs on 15 criteria. Of enterprise EMRs included in the study, Epic and VistA were neck at 5th and 6th, with McKesson 19th and Cerner 25th in line.

Now, in all fairness, it should be noted that the author of the blog item I mined for this piece is Edmund Billing, MD, CMO and EVP of Medsphere, whose product is OpenVista. But the stats outlined by Dr. Billing are worth considering nonetheless.

Perhaps we’re not ready for the religious wars to end, but throwing some relevant stats into the conversation couldn’t possibly hurt.  After all, there’s never a bad time to take physician perceptions seriously.